title: Alterations of the female reproductive system in islet recipient receiving immunosuppression.
abstract: Pancreatic islet allotransplantation is an option for patients with unstable type 1 diabetes mellitus (T1DM). Major improvements in islet isolation techniques and the implementation of steroid-free immunosuppressive regimens can maintain insulin independence in the majority of T1DM  for at least 1 year after transplantation. Recent studies have emphasized the impact of sirolimus on female reproductive tract. In this communication we report on the alterations of the female reproductive tract in 18 chronically immunosuppressed patients with T1DM following allogenic islet  transplantation. Previous research has shown development of ovarian cysts in islet transplant patients receiving sirolimus. We extensively reevaluated this and other possible side effects on the female reproductive system. These side effects have been underestimated, although they are significant,  requiring surgical or intensive medical treatment. Pre- and posttransplant gynecological evaluation should be performed to address the development of complications secondary to sirolimus in order to intervene sooner with alternative therapies.
authors.affiliation: Diabetes Research Institute, Miami, FL 33136, USA.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Del Olmo Garcia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lauriola
authors.forename: Altagracia Gomez
authors.initials: AG
authors.lastname: Aracena
authors.forename: Shari
authors.initials: S
authors.lastname: Messinger
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrales
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alejandro
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005836:Genitalia, Female / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation / Q000379:methods*; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus